Abstinence-only programs do not work

By Nina Carlina

The philosophy the government is adopting regarding sexuality education resembles that taken by many Christian strong states in the United States. Research done of the US has found that young people who have been taught abstinence  are just as likely to have pre-marital sex, and more likely to have sex without protection (since they are often taught it is wrong or useless). As a result, those states have been found to have the highest rates of teenage pregnancy and sexually-transmitted infections (STIs).

Given that youth taught abstinence are just as likely to have sex, it is just a difference of whether they have sex with guilt and internal conflict or they have healthy and safe sexual relationships.

In contrast to the United States, Netherlands has a successful sexual education program. They have the lowest rates of teenage pregnancy and STIs in the world, while the US has one of the highest rates of teenage pregnancy among the developed countries. A study by the Centers for Disease Control in 2008 found that a shocking one in four US teenage girls have STIs. The president of Planned Parenthood Federation of America said the study shows “the national policy of promoting abstinence-only programs is a $1.5 billion failure.”

Evangelical Protestant teenagers are more likely than Mormons, mainline Protestants and Jews to claim to believe in abstinence but are more sexually active than these groups. On average, white evangelical Protestants start having sex shortly after turning 16. Among major religious groups, only black Protestants begin having sex earlier.

Moreover, greater than half of those who take Christian abstinence pledges end up having sex before marriage, and not usually with their future spouse.

Evangelical Protestants are also significantly less likely than other groups to use contraception. Regnerus found that only half of sexually active teenagers who say they seek guidance from God or the Scriptures when making a tough decision report using contraception every time. In contrast, 69% of sexually active youth who say that they most often follow the counsel of a parent or another trusted adult consistently use protection.

Sexuality education in the Netherlands is non-judgmental in that it does not promote a negative view of pre-marital sex. Instead of focussing on whether sex is done or not, it emphasizes mutual respect in a relationship. Moreover, there is space for open discussion of perspectives in class, so each individual can come to a responsible and positive decision him or herself.

This has not resulted in the teenagers of Netherlands ‘jumping at’ the chance to have sex – most teenagers do not have sex until they are about 17. The world average is estimated at 17.3 and in the United States it is 15.8.

Research by Regnerus has found that adolescents who say that their families understand them, pay attention to their concerns, and have fun with them are more likely to delay intercourse, regardless of religiosity. This demonstrates that exposure to knowledge and societal openness does not make one more likely to engage in something – similarly, educating teenagers about safe sex does not make them more likely to engage in sex. It allows them the option of having safe sex should they decide to have sex. Advocates for Youth has found that societal openness and comfort with teenage sexuality is one of the two reasons for better sexual health outcomes for teenagers in the Netherlands as compared to the US.

Is it a bad thing to provide a comprehensive education of sex that is not clouded in shame and negativity, and that will help young people make positive, well-informed choices?

* * * * *

Sources and notes:

– “Red Sex, Blue Sex Why Do So Many Evangelical Teenagers Become Pregnant?” in NEW AMERICA FOUNDATION. Nov 3, 2008
– Mark Regnerus, sociologist at the University of Texas at Austin, published these findings in his book “Forbidden Fruit: Sex and Religion in the Lives of American Teenagers”.
– Findings based on a national survey by Regnerus and colleagues and a comprehensive government study of adolescent health known as Add Health.
– According to sociologists Peter Bearman, of Columbia University, and Hannah Bruckner, of Yale, communities with high rates of pledging also have high rates of STIs.
– Red states ( those that generally advocate abstinence-only education and are against abortion) have the lowest median age of marriage and highest teenage pregnancy rates, as compared to blue states ( those that support sex education and are not particularly against premarital sex).

http://www.nationmaster.com/graph/peo_tee_bir_rat-people-teenage-birth-rate which cites UNICEF.
– Regularly since 1998, Advocates for Youth has sponsored study tours to France, Germany, and the Netherlands to explore why adolescent sexual health outcomes are more positive in these European countries than in the United States. The United States’ teen birth rate is nine times higher than the Netherlands. Gonorrhea is the second most commonly reported infectious disease in the United States, and U.S. adolescent rate is almost 33 times greater than the reported teen rates the Netherlands.

25 Responses to “Abstinence-only programs do not work”

  1. 1 yuen 11 June 2010 at 18:14

    Joyce Elders, when she was US Surgeon General, agreed in answer to a question that girls should engage in masturbation as substitute for intercourse and reduce chances of premarital pregnancy; similarly, engaging in oral sex could help, since sex often occurs unplanned and contraceptive measures have not been taken.

    These are simply pragmatic issues, unrelated to moral questions of whether it is right or wrong to have sex in the situation; unfortunately, people do not take things that way; Elders lost her job after a public outcry.

  2. 2 Martha 11 June 2010 at 19:53

    A cynical person might suspect that a policy of “abstinence only” might be proposed in the full knowledge that it would most likely lead to an increase in teenage pregnancies, and begin to counter the very low birthrate.

    A cynical person might also wonder why, in a diverse society, any educational package, other than a contribution to religious education, should be provided by a small evangelistic religious minority.

    A cynical person would probably also want to know who the religious providers are, and whether they include “Focus on the Family”.

    • 3 Martha 11 June 2010 at 20:28

      Oh, I see it is.

      Surprising that the MOE says that “the facts” on homosexuality are going to be taught, but has approved providers that have been shown to be committed to spreading myths and ignorance on the subject.

      And using terms such as “promote homosexuality” on its website shows that it has already bought into those myths itself, and has insufficient knowledge of the subject to enable it to make an educationally valid decision about those who are qualified to teach about it.

  3. 4 Raphael Wong 12 June 2010 at 00:20

    Ahh people,

    Anti-Christian sentiment. Not surprising, of course.

    I am not surprised either that Joyce Elders was sacked. Rather than blaming a Conservative conspiracy, yuen, why don’t you try to imagine the effects of the “pragmatic” policies that Joyce Elder seeks to implement.

    Shall we have a “masturbation recess” in schools as well? Perhaps then girls can “safely” masturbate all they need to.

    Or perhaps, vacation for oral sex?

    The problem with all these measures is that it deals with the symptoms, but not the source of the problem. Yes, it may stop teenage pregnancies, and only may, but it would reinforce exactly the promiscuity that it is supposed to be neutral towards. The best way to stop teenage pregnancy is to stop teen sex, period.

    Sex occurs unplanned? Well, perhaps a little more thinking is required then, before doing anything that might lead to “unplanned” sex.

    “Abstinence-only” is a rather brutal way to react, but then it is in response to an equally brutal situation of promiscuity, whose symptom is “unplanned” teen pregnancies.

    Truly, the problem isn’t that they are “unplanned”; the problem is that they are “unwanted” and “unsupported”.

  4. 5 yuen 12 June 2010 at 00:40

    I did not mention either conservatives nor christians; however, since you mentioned these, I guess you are both

    I alao did not suggest “maturbation recess” nor “vacation for oral sex”; you are free to advocate them if you wish; hope you succeed where Joyce Elders failed

    • 6 yuen 13 June 2010 at 11:59

      one thing I learnt today about churches from Straitstimes: they pay high prices for 30-year land leases in order to build new churches; since this is operating on commercial basis similar to say social clubs, (e.g., Raffles Town Club paid $100M for a 30 year lease for a 100,000sq mt plot at Whitley/Dunearn), the organizatons probably also have to pay annual property assessments

      in other words, church congregations that pay 10% tithe are significant contributors towards government revenue, though indirectly – organizations that have stable revenue streams can obtain loans to make such investments, even if they do not have the endowment funds and freehold land that older establishments have; to some extent, this also explains the kind of outspokenness and influence we see – those paying want to call the tune

  5. 7 Raphael Wong 12 June 2010 at 01:11

    No, you did not advocate these, and I am not accusing you of doing so:-

    (1) The comments about Conservative Christians were not directed at you specifically, but at the article and the thread in general. I am a Christian. Whether or not I am a Conservative, I think is irrelevant to the issue, especially since the word “Conservative” is a very bad signifier of a view, as bad as the word “liberal”.

    (2) You did not advocate them, and I didn’t claim you did. And neither am I advocating them either. The point – although I agree that it should have been made less sloppily – is that these are logical outgrowths of the policy line that Joyce Elder was pushing for.

    There is no way to divorce policy from “the morality of sex in the situation”, as you do suggest. The issues you cited are not “merely pragmatic issues”, but moral ones as well. In fact, you yourself are operating from a moral presumption that premarital sex is not wrong in itself, which is still a debatable ethical position at the least, if not totally off-the-mark.

    If I were to advocate anything, I would advocate a detente and a dialogue between both parties. I am as disinterested in Liberal Triumphalism as I am in Conservative Tyranny. I believe that there is a false dichotomy being drawn between “no sex” and “sex with no restraints”. The latter is the revolutionary position, and the former is the reactionary position.

    • 8 SN 12 June 2010 at 10:22

      “There is no way to divorce policy from ‘the morality of sex in the situation’, as you do suggest. The issues you cited are not ‘merely pragmatic issues’, but moral ones as well. In fact, you yourself are operating from a moral presumption that premarital sex is not wrong in itself, which is still a debatable ethical position at the least, if not totally off-the-mark.”

      Bravo, Raphael.

      And, may I add: as if morals were a bad thing in the first place.


      • 9 yuen 12 June 2010 at 11:03

        “as if morals were a bad thing” – unrealistic moral standards are self defeating; they are more like constant nagging from parents/spouse – instead of changing your behaviour, you begin to ignore everything they say, including the correct things; you also hide things/tell lies in order to avoid nagging so thing end up worse

        I might add that my own children have turned out fine, without any need for nagging; you are of course free to practise some other approach in your own home

  6. 10 Raphael Wong 12 June 2010 at 01:17


    If you were truly cynical, why not be cynical about the opposite side as well? Why not be cynical about Planned Parenthood and PLU and Stonewall and all the “Gay Rights” Organizations?

    Why not be cynical about the people who support Joyce Elders?

    What about being cynical about how diverse society really is?

    How about cynical in the emphasis of condoms over abstinence? How about being cynical over the effectiveness of condom use? How about being cynical of the motives of “Sexual Health” companies like Durex, Pfizer and so on?

    How about being cynical about the need to restrict “religious” providers to “religious education”?

    How about cynicism as to how “Well-informed” people are after undergoing “comprehensive” sexual education programmes?

    After all, if you are not cynical about all these, then is your cynicism not hypocritical in itself?

  7. 11 yawningbread 12 June 2010 at 10:58

    The point of the article is that preaching abstinence does not work. On a practical test, the approach fails.

    Yet again and again we see a response that misses the point, a response that asserts (a) that moral (see below too) considerations are valid ones for determining what the response should be to pre-marital sex and (b) since the moral consideration points towards abstinence, therefore preaching abstinence is the appropriate approach to the tendency of unmarried people, including kids, to engage in sex.

    And there you see it…. Within 45 words, we have forgotten the point of Carlina’s letter: It does not work; on a practical test, the approach fails to deliver the outcome desired. It’s amazing, how quickly a debate that should be about practicality and effectiveness is erased and replaced with only the “moral” argument.

    Let me repeat: The point of the article is that preaching abstinence does not work. On a practical test, the approach fails.

    * * *

    The assertion that disapproval of pre-marital sex is a moral issue is problematic. It is certainly an issue of moralism, but it highly doubtful if it is a moral issue.

    I’m also struck by how quickly the conservative rhetoric established itself. Not the argument, the rhetoric, and by that I mean the way the first comment by Raphael Wong engaged firstly in diverting the discussion away from effectiveness to moralistic demands and secondly, in hyperbole, painting extreme scenarios (masturbation recess) for shock effect. It is so, so typical, of… guess what?…. the Religious Rightwing.

  8. 12 Stynium 12 June 2010 at 16:01

    Great letter by Nina Carlina – fantastic, top notch.

    Once again society is destroyed by clear and valid research showing that sexual education that teaches responsibility, contraception and pre-marital sex, gives us healthy, confident teenagers and adults free of STD’s and unwanted pregnancies.

  9. 13 Raphael Wong 13 June 2010 at 01:17

    Sigh Alex,

    I seriously didn’t think that you would give a different reply if you did give one, given the recent slew of anti-Christian articles you have been posting on your blog. But in any case, I am willing to engage in a constructive manner, so here goes:-

    (If you would put aside your leftist sympathies for a while and look across the fence …)

    (1) I wonder – is the issue here that “preaching abstinence” does not work, or that “abstinence” does not work? I would agree that the method of teaching abstinence needs an overhaul, but I see no reason why abstinence should be chucked out whole-sale and replaced by a condom-obsessed curriculum.

    And with such research, the first thing to ask is how the samples are derived, how you determine if someone is “taught abstinence” or not. My guess is that the criterion is terribly wide, and so the sample is unrepresentative. Also bearing in mind that such research, especially if it is done by a vested party such as Planned Parenthood, is likely to use skewed methodology.

    (2) So moral considerations are invalid, you say? You are deliberately fudging the issue here. You are mixing up the teaching of abstinence in principle with the way in which it is taught. While the latter may need some re-think, it is not necessitate the removal of the former as well.

    I am disturbed at the way you are pooh-poohing moral concerns.

    I am also distrubed by your lassiez-faire approach to the issue, which you disguise under the title “pragmatic”.

    There is no “tendency”, except that which is generated by Capitalist society e.g. condom companies.

    (3) I haven’t forgotten about the point of Nina’s letter, as you allege. I simply disagree with it nearly entirely.

    (a) PPF also has many skeletons in its closet, just that the media in the US is so biased towards it that they don’t tend to report its misdemeanours. More importantly, PPF is hardly an unbiased source of information, and exercises influence as a political lobby in the US Health System.

    (b) Teenage Pregnancies are a bad way to measure rate of teen sex. Since contraceptives are promoted, at least the chemical ones might have the effect of preventing pregnancies. And of course, for various reasons, teenage pregnancies are not reported.

    The people you derisively label the “right wing” argue that promoting pre-marital sex – even under the guise of “positive, informed choices” – leads to bad circumstances later on in life.

    One indicator is divorce rates. The Netherlands – with its “comprehensive” sex-ed program has a divorce rate of 38%, whereas we in Singapore only have a divorce rate of 17.2%. On that measure, it would appear that we have more community cohesion than the Dutch do.

    (c) A Conservative Evangelical would argue that abstinence, practiced properly, promotes mutual respect, not “shame and negativity”. The freedom which the left wing preaches is a false high; they have turned sex into the opium of the people. Incidentally, the rate of drug consumption in the Netherlands and in Scandinavia is very high.

    (4) “Practicality” and “Effectiveness” is all well and good, but just what is the target of all these?

    (5) Right and Wrong is a moral issue. And pre-marital sex, being a action done by humans, is subject to discussion of whether it is right and wrong. It is that simple. Your point here makes absolutely no sense at all. Your equivocation here is simply alarming.

    (6) I am also struck at how quickly the liberal rhetoric established itself. Not the argument, the rhetoric, and by that I mean the way all of you skewed the issue from whether abstinence is something that should be taught, to using it as a way to attack Christians for their viewpoint. It’s so typical of … guess what? Left-wing Atheist demagogues (like Christopher Hitchens).

  10. 14 Raphael Wong 13 June 2010 at 01:22


    And why should any pregnancy be “unwanted” in the first place?

    Is contraception “Responsibility”, or merely a way to shirk responsibility for your own actions?

    Your left-wing assertions beg better support.


    Incidentally, the USA does not have a single sexual education program, because it varies from state-to-state.

  11. 15 jem 14 June 2010 at 13:56

    I can’t help but get the impression Raphael Wong would very much like to be the supervisor for his masturbation recesses.

    • 16 Raphael Wong 14 June 2010 at 19:07


      And why would I like to be the supervisor for something this obscene? (And even Alex admits that it is obscene.)

  12. 17 Jeremy 15 June 2010 at 03:31

    Masturbation Recess, maybe that’s what we need in this insane insane world of ours! Time to loosen up guys, since everybody’s going to fornicate eventually, why not arrange for us to come together at the canteen for a let-go and a boom-bang after sex education classes? Even a seminarian (the one who survives on a diet of semen) would agree. Of course, this is merely one practical suggestion of mine.

    • 18 Jeremy 15 June 2010 at 03:33

      satire aside, i think Raphael should try to understand the difference between sexual education & sexual policing. monumental condom between the two concepts.

  13. 19 Chris 15 June 2010 at 13:58

    Morals defined by the Merriam-Webster Dictionary is “of or relating to principles of right and wrong in behaviour. Who sets these principles of right and wrong? Who sets these moral standards? The Bible, the Qu’ran, the Kabbalah, the Buddisht Scriptures or etc. What if I do not practise any religion then who sets these moral standards for me? I know some will start their outpour on preconceived notion of morals in the society on a whole, but then again what give rise to these preconceived notions?

    I am not judging whether the abstinence-only program is going to work. But, if I am to receive a sex education, I want to receive a complete package of information and not a biased view of a conservative, a liberal or any one religion. The curriculum of the sex education should include abstinence but should not be abstinence-only or abstinence focused.

  14. 20 yawningbread 15 June 2010 at 14:12

    General response to a number of comments above:

    It’s very clear from Nina Carlina’s article and my earlier comment that the issue is that of a sex education package that is heavily focussed on abstinence with either neglect or disparagement of other considerations. That being the case, the issue is not abstinence, but the preaching of abstinence.

    If you even read the piece I wrote just prior to Nina Carlina’s, you’d see I feel abstinence must be positioned as a desirable option for teenagers. What I object to is any attempt to position it as the ONLY approved option, with all the guilt-inducing, silence-enveloping result for other routes that young people may choose to take.

    Specific response to Raphael Wong (13 June 01:17):

    Raphael – before you take issue with the empirical evidence that Carlina has presented, how about presenting the empirical evidence to show that preaching abstinence works? My understanding is that Carlina has only cited the tip of the iceberg in terms of the numerous studies that more or less come to same conclusion – that it does not. This is a classic Religious Right response, seen again and again, of poking holes at the other side’s evidence without offering any of their own.

    There is also a big difference between morality and moralism. Morality pertains to the governance of the self according to notions that are pretty much universal, such as honesty, fairness, compassion, respect for the dignity and privacy of others. Moralism is the promulgation of rules to govern others; they are usually social, cultural or religious constructs of limited applicability, i.e. to certain communities only who share the same theocratic, cultural, historical source assumptions and environment.

    There is the never-ending attempt to confuse moralism with morality, an attempt we must be alert to. To cloak moralism as morality and then argue that education cannot but promote morality is to mightily confuse the issues.

    Indeed sex education must include a big dose of morality, and that’s why good sex education packages speak of respect for individual choices, respect for sexuality differences, about sincerity and responsibility towards one’s partner in relationships, about honesty in expressing one’s feelings, fairness in sharing, etc. But don’t confuse moralism with morality.

    I see the falsity in the statement that “morality” is a valid component of sex education when the speaker actually means moralism.

    One last thing: Raphael said “One indicator is divorce rates. The Netherlands – with its “comprehensive” sex-ed program has a divorce rate of 38%, whereas we in Singapore only have a divorce rate of 17.2%. On that measure, it would appear that we have more community cohesion than the Dutch do.”

    Divorce is not a bad. In many ways, it is a good. Lots of people stay in unhappy marriages slowly killing themselves emotionally for too long. Artificially prolonged marriages also indicate power imbalance between one party and another which usually signifies gender oppression. And since when is divorce a measure of “community cohesion”?

  15. 21 Raphael Wong 15 June 2010 at 16:27


    (1) A natural inclination towards or against a particular action, in the absence of biases. Whether you want to believe that this is from God or from Evolution is up to you. (Although honestly, I don’t see the difference; but that is another debate.)

    (2) I am interested – what do you consider the “biased view” of a liberal?

  16. 22 Raphael Wong 15 June 2010 at 17:25


    (1-2) I was not responding to your earlier articles, so mentioning them is moot. Plus, if memory serves me right, I remember that in school sex education was part of the science syllabus as well, and that is not under any religious group’s – Christian or otherwise – control. I don’t think that much has changed since then.

    If I get MOE right, I would say that these “sex education providers” which you rail so much against are merely auxilliary services in MOE’s scheme of things.

    (2) Abstinence is promoted as the best option, not the only option. And certainly, it is the best option to prevent teen pregnancies entirely. Even if the statistics from condom companies – who are vested interests in the “sexual health”/”sexual pleasure” business – are to be trusted, it is a fallacy of division to assume that the probability for each individual is equal to the statistical property of the whole.

    (3) I love the fact that you assume instantly that it is “the tip of the iceberg”. Or are you just letting your own prejudices run amok?


    I was critiquing Nina’s response, so I was not obligated to provide evidence for the counter-case, but since you press…




    If any of these are unreliable, then it is only as unreliable as Nina’s sources.

    And one more point of Nina’s sources: How is one certain that the causation is only one-way? (i.e. from Abstinence-only outwards?)

    (4) Do you not realize that this is a special pleading argument? Slapping on the term “Religious Right” merely adds on a Poisoning-the-Well fallacy.

    (5) I would contend that you are drawing a distinction where there is none.

    (7) And that is your Moralism. Moralism, unlike how you define it, is the imposition of one’s moral code on others, which is exactly what you are doing here, only in the reverse direction to those whom you criticize. What is “respect”, “honesty” and “fairness”?

    And is not the issue of “sexuality differences” still up for debate (along with its philosophical grounding)? Naturally, by your bias, it isn’t, but that is yours working.

    (8-9) That is because you are not seeing the big picture. The question is not whether people stay in unhappy marriages or suffer from gender oppression (which sometimes becomes an abused term). The question is why people end up in these situations in the first place.

    Yes, Divorce is “a good” for exiting these circumstances, but it is a symptom of the causes of entry into these circumstances, which should be dealt with appropriately.

    Divorce is a measure for social cohesion because it measures how well relationships in society are maintained. And not just that of the divorcees, but also the other ancillary relationships affected by the divorce.

  17. 23 Chris 16 June 2010 at 10:53

    Morals and natural inclination is just going to lead to a debate of nature versus nurture (or as you want to put it God versus evolution). Not a debate which any side is going to prevail.

    The question chould be “What does a conservative consider the “biased view” of a liberal?”

    • 24 Raphael Wong 16 June 2010 at 18:45


      I would wonder too … what does a liberal consider as the “biased view” of a conservative?

      And no, that’s not quite how I phrased it. My phrasing would be: God/Evolution versus Man. Although it might not be a debate where any side can prevail, it is a necessary debate to have.

      And having any single side prevail is not always the best option. I would that it were a dialectic discourse, as opposed to a debate. That way, both perspectives get to reinforce each other, and hopefully coalesce into a bigger picture, which covers all angles.

      A tip: what is the difference between procreation and reproduction?

  18. 25 Jon 20 June 2010 at 08:58

    “What do you as a liberal/conservative believe?” is an important question. I think that disagreements like this stem from differences in fundamental/axiomatic beliefs. Without uncovering and resolving those differences in beliefs, conservatives and liberals are doomed to shouting at each other in languages that the other side simply cannot understand. No amount of fact can resolve the dispute.

    I think that one of the key differences between liberal and conservative worldviews is the moral system they privelege over all others. I think that conservatives tend to believe that there is a single measure of “right” and “wrong” whereas liberals seem to feel that everyone is entitled to a different interpretation of morality. (not making value judgements here…)

    This comes back to YB’s comment about morality vs moralism. For a conservative, since there is only one correct moral code, there is nothing wrong with structuring society to
    enforce that code. For a liberal, respect for what others perceive as right or wrong is paramount (why else privelege “fairness, compassion and the dignity and privacy of others”?). Hence liberals choose to cite objective facts, as if the disagreement was ever about the facts in the first place!

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